Posted: 16/11/2023
How, and how much you are monitored during labour will depend on several factors, including how the labour is progressing, the type of delivery you are having, any background problems with your health or the baby, and your preference.
Your midwife will usually check your blood pressure, pulse, and temperature regularly during your labour. They will also likely check your urine. Your contractions should be monitored for duration, frequency, and strength. Usually, you will be offered vaginal examinations to check how dilated the cervix is at regular intervals throughout the labour.
The midwife or doctor will usually also monitor the baby, including their heart rate. This can be done in two main ways: intermittent and continuous monitoring.
Intermittent monitoring is usually advised in uncomplicated labours. It is done using a stethoscope or a handheld machine held against your abdomen, in order to detect the baby’s heartbeat. This is something that should be explained to you, and your consent should be sought. Intermittent monitoring is generally done every 15 minutes during active labour.
The benefit of monitoring in this way is that you should still be able to move around, or use a birthing pool, as you will not be connected to continuous monitoring equipment.
If there are complications, the midwife or doctor may advise continuous monitoring. Again, this is something that should be explained to you, and your consent is required.
Continuous monitoring is usually done by attaching two monitors to your abdomen, one of which records your contractions, with the other recording the baby’s heart. Alternatively, the device to monitor the baby may be inserted via the vagina and attached to the baby’s scalp.
You could be advised to have continuous monitoring if you are suffering from an infection, if there is meconium (the baby’s stool) in your waters, if you have high blood pressure, diabetes, have had bleeding, or if you are having an induced labour or an epidural. You may also have continuous monitoring if the baby is small or premature, if you are having twins (or more), if the baby is breech or if there are other problems detected with the baby.
The heartbeat and contractions will be displayed on a screen on a cardiotocograph (CTG) or trace, which is interpreted by the midwife or doctor.
When the uterus contracts during labour, blood does not flow easily through the placenta and so the baby’s oxygen supply decreases. Most of the time the baby can cope with this but monitoring the baby’s heart rate during labour helps determine if there are any signs of distress or harm to the baby. If there are, it may be time to discuss changing the birth plan. Interventions such as assisted birth (using forceps suction) or caesarean section may be needed, to deliver the baby more quickly.
Failure to adequately monitor during labour, to correctly interpret the results of monitoring, and to act upon those results correctly or swiftly enough, can lead to oxygen loss for the baby. This can cause brain damage, conditions such as cerebral palsy, and, in some cases, even death. The more quickly a lack of oxygen is recognised, the faster doctors can intervene to deliver the baby before significant damage is done.
If you or a family member have concerns regarding care provided during childbirth, please contact us on freephone 0800 328 9545, email clinnegspecialist@penningtonslaw.com or complete our online assessment form.
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